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Monday, March 21, 2011

We all love(d) our grandparents, of course, and I have nothing but fond memories of mine. My mother’s father was a truck farmer who owned 40 acres on Staten Island. I remember his really rough hands. Every week he drove his chain-drive, solid-tired, flat-bed truck through the Holland Tunnel to the Washington Street market before dawn. There, he sold crates of vegetables at the wholesale market where the World Trade Center was later to be built. He and his wife, my grandmother, were both fat and died at about age 75, he of lung cancer (he loved cigars) and she of Alzheimer’s.

My father’s father died at age 79 when I was only 8 but his wife, my grandmother lived to be 89 and was skinny all her life. She hadn’t eaten a tomato since 1895. Poison, she said, nightshade family. So are potatoes, of course, and eggplant, Bell peppers, chili pepper, paprika, tobacco, petunia, and belladonna (deadly nightshade). So far, they haven’t killed me. (Aside: When my wife read this column in draft, she told me her father ate unripe tomatoes as a kid and got really sick.)

I did not derive any enduring wisdom about eating from any of my grandparents. I wasn’t asking, and they weren’t saying, but YMMV (Your Mileage May Vary), to use internet slang. Increasingly, however, we hear this advice: Don’t eat any food that didn’t exist when your grandmother went food shopping, or don’t eat anything that is sold in a box or a bag; or has more than 4 ingredients; or has things in it that you can’t pronounce. In other words: eat whole, unprocessed, unrefined foods. In sum, as Michael Pollan says, “Eat Real Food”. I think that’s good advice, as far as it goes. It’s a start anyway. And you have to start somewhere if you want to improve the quality of your life and avoid getting a “progressive” dietary disease like Type 2 diabetes, or even a syndrome. Woe is me, not Metabolic Syndrome!

It’s easy to make these pronouncements, but we all lead busy lives and preprocessed foods are convenient. Besides, dietary advice is constantly changing and so much is still unknown and uncertain. Low-fat, low carbohydrate, who’s to know? Your doctor’s in charge of your health, right? And the government knows best. Well. Now you’ve gone too far for me, but if you’ve reading this column (archived at http://danbrown-thenutritiondebate.blogspot.com), you know this.

So, as it turns out, our grandparents made smart food choices by default! Real Food was the only option they had. But in truth there were bad choices they could have made and did make. White flour was preferred because it kept longer. And farmers have been breeding fruit to be sweeter for hundreds of years (at least), increasing the fructose load that our livers have had to deal with to protect our bodies from its toxic effects. So, fruits got sweeter, and more fructose went directly to the hepatic portal vein without the usual oxidative metabolism required of glucose. Then sucrose (table sugar), a disaccharide of refined cane sugar containing equal parts fructose and glucose, replaced molasses, and was added to lots of foods. Now, high fructose corn syrup (HFCS) is commonly used to sweeten foods and beverages. Our livers are in fructose overload. As a result, non-alcoholic fatty liver disease (NAFLD) is now on the increase.

And as we try to avoid saturated fat, as recommended by the “Dietary Guidelines for Americans” (see installment #14), we are 1) eating more and more monounsaturated fats like olive oil, which is otherwise a “good” fat but which is more likely to become added body fat than saturated fats and 2) eating too much polyunsaturated fat, which tends to be partially hydrogenated trans fats and also contributes to an unhealthy ratio of Omega 6’s to Omega 3’s.These PUFA’s are often hidden in baked goods and in fried foods that are cooked in high-heat vegetable oils that are used repeatedly. Repeated use destroys the delicate omega 3’s and oxidizes the rest. Oxidation = rancidity.

Now, add to all this the refined grains. Although the Dietary Guidelines don’t tell you this explicitly, “refined grains” means anything made with bleached, enriched, white flour from wheat, or any other refined (milled, bleached, enriched etc.) grains. I’m not telling you this. The “Guidelines” are telling you this. They just can’t say it in so many words without getting the Industrial Agricultural Complex mad as hell. They already have the beef and lamb and pork industries up in arms. They can’t afford to get Archer Daniels Midland and Cargill up in arms too. Besides, their representatives were on the Dietary Guidelines Advisory Committee, so there wasn’t much danger of that. So was the Center for Science in the Public Interest (CSPI), the quintessential nanny-state advocacy organization. Together, these groups are now in the driver’s seat of my grandfather’s chain-drive, solid-tired, flat-bed truck on the way to today’s market. Personally, I hope that market will eventually “move” too, the way the Washington Street Market did to make way for the Twin Towers.

Friday, March 11, 2011

My heart is pounding, and I’ve only just re-read the Executive Summary of this year’s long awaited “Dietary Guidelines for Americans, 2010” (www.dietaryguidelines.gov). I had listened live to the press conference on January 31, 2011, when it was released to the public, and had managed to calm myself since, but now my blood is boiling again. Where to begin?

First, to be fair, the government’s “Dietary Guidelines” is a public health document, and a public health recommendation is geared to an entire population with a broad purpose which is often interpreted by a much narrower segment to which it may not be applicable. There is much too much variability within the population for such broad pronouncements to edify or be efficacious; but they are made nevertheless in the broad interest of “the public health.” So, if you’ll pardon the expression: “take it with a grain of salt.”That being said:

This year’s “Guidelines” are cleverly crafted by wordsmiths with skills for euphemism: “(A)t a time of rising concern about the health of the American population…,” we are told that “poor diet” and “physical inactivity” are “associated with major causes of morbidity and mortality” in the US. True enough. Then, we are told that “15 percent of American households have been unable to acquire adequate food to meet their needs.” Then, “This dietary guidance can help them maximize the nutritional content of their meals,” and “Many other Americans consume less than optimal intake of certain nutrients even though they have adequate resources for a healthy diet.” Again, all this is certainly true.

Parsing those words, they mean that on limited incomes many people make poor food choices, and the government wants to help. I’m reminded of a headline I read in Honolulu last September that 50% of Hawaiian residents were on food stamps. The government dole, not the pineapple company, helps these poor folks survive in paradise.

So, the guidelines start with several iterations of the obvious, universally-held truth (NOT) about the “Energy Balance Equation: Energy In = Energy Out,” (see installment #6 at http://danbrown-thenutritiondebate.blogspot.com). Then the “Guidelines” summarize the “key recommendations” this way: “Americans currently consume too much sodium and too many calories from solid fats, added sugars, and refined grains. These replace nutrient-dense foods and make it difficult for people to achieve recommended nutrient intake while controlling calorie and sodium intake. A healthy eating pattern limits intake of sodium, solid fats, added sugars and refined grains and emphasizes nutrient-dense foods and beverages – vegetables, fruit, whole grains, fat-free or low-fat milk and milk products, lean meats and poultry, eggs, beans and peas, and nuts and seeds.” I could, and will, quarrel with some of this in later installments, but not bad so far.

A little later we are told where to find a meal plan with such a dietary: “Two eating patterns that embody the Dietary Guidelines are the USDA Food Patterns and their vegetarian adaptations and the DASH (Dietary Approaches to Stop Hypertension) Eating Plan. I haven’t gone there yet (I will), but first I want to characterize the “Key Recommendations.”

There are seven “foods and food components to reduce” and nine “food and nutrients to increase.” We’re told to reduce our sodium intake, consume less dietary cholesterol, keep trans fat from synthetic sources as low as possible, limit saturated fat by replacing it with mono and polyunsaturated fats (hmmm), and limit refined grains, “especially refined grain foods that contain solid fats, added sugars and sodium”…and limit alcohol consumption. By word association, they unfortunately and erroneously link trans fats and “…other solid fats,” and “solid fats and added sugars” as things to be reduced or avoided together. In recommending the substitution of mono and polyunsaturated fats for saturated fats, they are stepping into a trap of their own making they will rue and wish they had avoided in the years to come. I will speak to this in later installments. And note, if it wasn’t already clear, that “solid fats” is a new term in the “Guidelines” and a euphemism for saturated fats, which in our dietary is almost entirely animal fats, the only exceptions being the tropical oils (coconut and palm), which are not common in most people’s daily “food pattern.”

Of the food and nutrients to increase, recommended are fruits, vegetables , whole grains plus some vitamins and minerals (as supplements if you can’t get them in “real” food); but, five of the nine recommendations were ways to avoid saturated or “solid” fats, including eating “beans and peas, soy products, and unsalted nuts and seeds” and “fortified soy beverages.” I may just have to look at those “USDA Food Patterns and their vegetarian adaptations” after all. But first, I want to examine what Grandma knew about food patterns, and then what Michael Pollan is telling us.

Thursday, March 3, 2011

Why, you ask, do I see the ship of state-guided nutrition turning slowly? There is lots of evidence that can be pieced together to demonstrate the slight shift that I see away from carbs to – dare I say it? – fats. First, the news about carbs:

The current AHA guideline point out that added sugars (note: all sugars are 100% carbohydrate) should be limited. To see how much sugar is in everyday foods, the website www.sugarstacks.com is a quick link and very illuminating.

“Good Carbs and Bad Carbs.” The Glycemic Index differentiates between quick acting carbs, from simple sugars and highly refined carbohydrates, and the slower digesting “complex” carbohydrates. The food industry picked up on this right away, and we are now deluged with entreaties to eat this or that processed food product made with the slower-digesting whole grains. The latest guidelines suggest that half of all the grains you eat should be “whole.” That’s a start.

However, a carb is a carb is a carb, and the area “under the curve” is the same no matter the source of the carbohydrate. Whether it spikes the blood sugar, or it takes longer for the blood sugar to rise but then stays high for a longer time until the glucose is all “taken up,” it still works the pancreas. Still, spikes are best avoided as they can lead to neurological damage as well as the development of glucose intolerance and insulin resistance.

Unfortunately, the Glycemic Index just tells us there are “spiking” carbs and “non-spiking” carbs; it does not tell us to eat fewer carbs, and it does not make it clear that the Glycemic Index is not “one size fits all.” It also neglects to mention that fats will not spike your blood sugar; in fact, they won’t even raise it.

“Good Fats and Bad Fats”: We all know to avoid trans fats. Margarine, as originally constituted, was made from partially hydrogenated vegetable oils that were constituted as trans fats. We ate margarine to avoid butter, which is a mostly “saturated” fat (66% saturated, 30% monounsaturated, and 4% polyunsaturated). But, trans fats are also found in common vegetable oils used for frying, and in baked goods on the grocery store shelf. Look for “partially hydrogenated vegetable oil” in the ingredients list and don’t buy foods that contain these trans fats!

The processed food industry/big government cabal are now trying to lump trans fats together with saturated fat, and by association taint, indeed vilify, saturated fats (as if they thought the public needed to hear it further declaimed!). So, saturated fats remain the “bad boy” of allowed fats, and are “limited” in the establishment guidelines to no more than a 3rd of total fats, which are themselves limited to no more than 30% of total calories. Interestingly, to further limit saturated fats, which are only found in animals and tropical oils, the newest HHS/USDA “Dietary Guidelines for Americans, 2010,” released on January 31, 2011, recommends a shift away from these “solid” (saturated) animal fats to “a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts and seeds.” Translation: a “vegan” diet! Are you ready for that? More on the new Dietary Guidelines in the next column in this series.

Omega 3 vs. Omega 6 Fatty Acids: Omega 3’s and Omega 6’s are both polyunsaturated fatty acids, which along with monounsaturated fats (olive oil, etc,) are the two types of unsaturated fats. Unsaturated fats, generally in the form of oils, are viewed in the conventional wisdom as preferable to saturated fats. Olive oil and the other monounsaturates are good. The problem is we are eating too many of the polyunsaturated fats in processed foods made with the Omega 6 vegetable oils, and too few Omega 3’s. The ratio needs to be corrected. So, in this latest shift in guidance, we are being encouraged to eat fewer 6’s, and to supplement our intake of Omega 3’s, usually in the form of fish oil capsules. But, how much fish oil can you eat? The solution: drastically reduce the amount of Omega 6’s in your diet. Much more on that later too.

This brings us to eggs: Egg yolks are high both in saturated fat (36% by weight) and cholesterol (212mg/large egg). The latest guidelines still reflect the mistaken idea that the cholesterol you eat directly affects your blood cholesterol levels. So, two large eggs contain more than the recommended daily amount of cholesterol (300mg). But, eggs contain all of the essential amino acids for humans. Loaded with vitamins and minerals, they are an inexpensive source of protein and fat.

But there’s hope. Butter sales are on the rise again, and eggs from pastured (“free range”) chickens are in the farmers’ markets. I even overheard a segment on the Today Show recently that advocated “eat fat to lose fat.” Now, I ask you: How far off can the shift to healthy eating be if a mainstream network like NBC is willing to promote a crackpot idea like that?

About Me

I was diagnosed a Type 2 diabetic in 1986. I started a Very Low Carb diet (Atkins Induction) in 2002 to lose weight. I didn’t realize at the time that it would put my diabetes in clinical remission, or that I would be able to give up almost all of my oral diabetes meds. I also didn’t understand that, as I lost weight and continued to eat Very Low Carb, my blood lipids would dramatically improve (doubling my HDL and cutting my triglycerides by 2/3rds) and that my blood pressure would drop from 130/90 to 110/70 on the same meds.
Over the years I changed from Atkins to the Bernstein Diet (designed for diabetics) and, altogether lost 170 pounds. I later regained some and then lost some. As long as I eat Very Low Carb, I am not hungry and I have lots of energy. And I no longer have any of the indications of Metabolic Syndrome.
My goal, as long as I have excess body fat, is to remain continuously in a ketogenic state, both for blood glucose regulation and continued weight loss. I expect that this regimen will continue to provide the benefits of reduced systemic inflammation, improved blood lipids and lower blood pressure as well.